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   Table of Contents - Current issue
April-June 2020
Volume 69 | Issue 2
Page Nos. 65-117

Online since Tuesday, June 30, 2020

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Namaste: The traditional indian way of greeting goes global during coronavirus disease (COVID-19) pandemic p. 65
Rashi Singh, Gaurav Singh, Vishram Singh
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Radiological study of the adipose tissue at the para-cavernous region of middle cranial fossa p. 67
PV Santosh Rai, Anees Dudekula, Anand Venugopal, BV Murlimanju, Muralidhar Pai, Sampath Madhyastha
Introduction: The cavernous sinus (CS) lesions are difficult to identify on computed tomogram (CT) film, and the subtle changes may help in the diagnosis. The objective of the present study was to examine the para-cavernous adipose tissue in the CT scan in the Indian population. Material and Methods: The study included 100 patients of all age groups, who were examined using a 16 slice multidetector CT. The axial images were analyzed for the presence of adipose tissue on either side of the CS. The intracranial pathology and atrophic changes, if any, were noted. Results: The present study observed that 17% of the patients had intracranial pathologies. Among the 83% of patients with no pathology, paracavernous adipose tissue was observed in 85.5% and 89.2% over the right and left sides, respectively. It was observed that the paracavernous fat was visualized in higher frequency in elderly adults. It was visualized in all the patients (100%) of over 60 years. In some patients, with mass effect, the paracavernous fat was obliterated over the ipsilateral side, but it was visualized on the contralateral side. Discussion and Conclusion: The present study suggests that the CS lesions are difficult to identify on the CT scan, and the subtle signs may help in making a diagnosis. The para-CS adipose deposit is one among these subtle changes; if there is the presence of adipose tissue on one side and its absence on the other side, then pathology should be suspected.
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A comparative analysis of morphological parameters in south indian hip joints with review of literature p. 71
Supreeth Nekkanti, Alok Moogali, Arun Mahtani, Mruthyunjaya
Introduction: The morphology of the proximal femur is an essential parameter in the design and development of implants for total hip replacement. Inappropriate implant design and size could affect the outcome of the surgery with reported complications such as stress shielding, micromotion, and loosening. Most of these implants are designed and manufactured in the European and North American regions, which are presumably based on the morphology of their respective populations. In this study, we try to demonstrate the significant variation in the morphology of South Indian hip joints compared to other ethnicities. Material and Methods: This prospective study includes the study of the morphology of 400 adult hip joints. The patients presented to our hospital with complaints other than that related to the hip joint. Various parameters were studied, comprehensively discussed, and compared with other studies done in different ethnic groups. Results: The hip joints of the South Indian population have a significantly smaller femoral head diameter and offsets, narrower neck width, and medullary canal diameter when compared to other ethnic groups. The neck-shaft angle was comparable to results from other studies. Gender- and laterality-based variations were observed as well. Discussion and Conclusion: Our study demonstrated that the South Indian hip joints are significantly smaller when compared to other Asian hip joints. There were significant gender- and laterality-based variations. This study also provides evidence that implants could be modified to replicate the morphology of the native hip joints.
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Association between the pectoral muscles and rib anomalies in poland syndrome p. 81
Arife Zeybek, Kürşad Tosun, Ceren Uǧuz Gencer, Serdar Kalemci, Necdet Öz, Sena Çalışkan, Huriye Gülistan Bozdaǧ
Introduction: The purpose of this study was to investigate the relationship between pectoralis major muscle (PMj) and rib defects in Poland syndrome (PS) and to evaluate the clinical findings and variabilities by the systematic review of all/current published articles on PS. Material and Methods: Based on our inclusion criteria, 86 patients were decided to be eligible for participating in this study. The data of the reviewed studies were classified according to the date of publication, age, sex, side of the deformity, defect type of PS, presence of other muscle or chest wall abnormalities, and dextrocardia. Further, other coexisting deformities and abnormalities were recorded. A logistic regression statistical analysis was carried out. Results: According to the reviewed cases, both left-sided presence-multiple muscle defects and left-sided presence-rib anomalies were found to be statistically significant (P = 0.007 and P = 0.04, respectively). The strength of the relationship between these two parameters was evaluated by binary logistic regression analysis, which revealed that multiple muscle defects and rib anomalies were associated with left chest side presence (P = 0.005 and P = 0.02, respectively). When the relationship between rib anomalies and PMj defect was analyzed, the association was found to be statistically significant (P = 0.03). Furthermore, the result of the strength analysis was also supported this association (P = 0.04). Discussion and Conclusion: Molecular and embryological development processes of the ribs and pectoral muscles are investigated to assess the presence of a structural relationship considering the causal connection between ribs and PMj in PS. As a supportive element to our study, the presence of a myogenic regulatory factor–Hox gene link was asserted in the animal experiments done by some researchers, showing a common development process of the rib and pectoral muscle. We believe that with the outcomes of this study, the clinical diversity and the etiopathogenesis of PS could be explained comprehensively.
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Assessment of accessory mental foramen using cone-beam computed tomography and its clinical relevance p. 91
Milos Z Zivic, Miroslav R Vasovic, Aleksandar B Acovic, Ana Z Lukovic, Ivana K Zivanovic-Macuzic, Milica M Velickovic, Tatjana V Kanjevac
Introduction: Accessory mental foramen (AMF) is defined as any additional opening on the anterior surface of the mandible body that is connected to the mandibular canal. The presence of AMF is an important anatomical parameter when planning the therapy to avoid neurovascular bundle injury and other complications. Cone-beam computed tomography (CBCT) provides an accurate, three-dimensional determining of the position, its dimensions and the relation of AMF to the mental foramen (MF), as well as the distinction from nutritive openings. Material and Methods: The research was carried out at the Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, as a retrospective study where 148 CBCT images were analyzed. The analysis of the position of AMF, the relation to and the distance from the MF were made on cross-sectional and axial images. Only those openings that have had a clear connection with the mandibular canal were counted as AMF. Results: AMF was present in 12 (8.11%) patients. In most cases, AMF was positioned superior to MF, in 27% of patients. There was no significant statistical difference between sex and the jaw side. The average distance of AMF from MF was 4.52 ± 2.21 mm. In most cases, AMF is round shaped (60%). The average value of the surface area is 1.62 ± 1.14 mm2. Discussion and Conclusion: Timely detection of AMF using CBCT contributes to the diagnosis and planning of appropriate dentures, surgical technique, preventing possible damage to adjacent anatomical structures, or some other therapy.
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A study on differences in the obliteration of cranial sutures and their clinical significance p. 97
Md Tabrej Alam, Venkatesh G Kamath, N Hema, AK Srivastav, Seema Patil
Introduction: There are very few studies on the patency of cranial sutures, and this study analyzes the difference in sutural patency. The objective was to study the difference in the patency of coronal, sagittal, and lambdoid sutures in Indian human adult skulls. Material and Methods: This study involved 120 Indian human adult skulls. The suture patency was graded in accordance to a classification proposed by Sabini and Elkowitz on a scale of 0–4. An open suture was classified as 0; fused but not obliterated as 1; and Grades 2, 3, and 4 represented <50%, >50%, and 100% of obliteration, respectively. Results: The lambdoid sutures were observed to be the most patent and least obliterated. Grade 1 sutures were observed to be 44.71% in lambdoid, 8.4% in sagittal, and 7.3% in coronal sutures. Grade 2 sutures were observed to be 42.6% in lambdoid, 49.3% in sagittal, and 46.7% in coronal sutures. Grade 3 sutures were observed to be 10.1% in lambdoid, 32.1% in sagittal, and 36.2% in coronal sutures. Grade 4 sutures were observed to be 2.6% in lambdoid, 10.2% in sagittal, and 9.8% in coronal sutures. No open sutures were observed. Discussion and Conclusion: Lambdoid sutures are more patent than coronal and sagittal sutures. This can be attributed to the presence of more muscular contractile forces acting on the lambdoid suture when compared with other sutures. The mechanisms involved in suture closure are complex and involve genetic and environmental factors, age, and tissue interactions. Therefore, more advanced research is essential for a clearer insight on this subject, which has immense clinical implications in neuroscience.
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A review of flaps and their uses in reconstructive surgery p. 103
M Sivakumar, Devi Prasad Mohapatra
The field of reconstructive surgery is rapidly advancing with advances in the techniques of anatomical dissection, understanding of the neurovascular physiology, and improvements in surgical instrumentation. Flaps are composite units of tissue which have their own blood supply or an intact arteriovenous system to receive vascular inflow when transferred to a site of defect. Due to a wide array of flaps being used in reconstructive surgery, numerous terminologies can be found in use by reconstructive surgeons. Skin flaps are flaps that are composed of skin and subcutaneous tissues. Composite flaps are those which contain more than one component within the flap substance, and perforator flaps are those based on a cutaneous perforator. The angiosome concept has aided in understanding the vascular basis of flaps and increases their utility. Further research and insights are needed at the moment to have a finer understanding of the tissue neurovascular anatomy and flap behavior.
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Superficial course of the radial artery in the anatomical snuffbox and course of princeps pollicis and first dorsal metacarpal arteries p. 110
Billakanti Prakash Babu, R Huban Thomas
Variations of the radial artery (RA), in its course and branching pattern in the anatomical snuffbox, are clinically significant during vascular and reconstructive surgeries of the hand. During the course of routine dissection of RA in the forearm and hand, an important variation was noted. In one of the cadaver RAs, at a short distance above the wrist, it gave superficial palmar artery and turned laterally passed superficial to the tendons to the thumb forming the boundaries of anatomical snuffbox and entered the hand by passing between two heads of the first dorsal interosseous muscle and terminated in the deep palmar arch. At the anatomical snuffbox, RA gave arteria princeps pollicis and first dorsal metacarpal arteries. The knowledge about this variation is to be noted carefully because this artery used as a graft during the cardiac surgery, which when missed might lead to many complications.
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Cartilaginous choristoma at nasopharynx p. 113
Santosh Kumar Swain, Smrutipragnya Samal, Jatindra Nath Mohanty
A 26-year-old man attended the outpatient department of Otorhinolaryngology with complaint of nose block. He was presented with nonspecific clinical presentations except nasal block. Mass was present at the nasopharynx and completely excised and sent for biopsy which confirmed the diagnosis of cartilaginous choriostoma. The histopathological report revealed cartilaginous tissue with surrounding of seromucous salivary glands under cover of respiratory epithelium. The choristoma is a tumor like lesion consisting of normal cells present in the abnormal site. It is most often seen in oral cavity structures such as tongue, gingival, buccal mucosa and soft palate. Cartilage choristoma is rarely found at the nasopharynx. It is developmental in origin. Definite diagnosis is done by histopathological findings. The treatment is usually done by the surgical excision.
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Prof. Asim Kumar Datta (1927–2020) p. 116
Ranjit Guha
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